Stage 2: 3 to 4 weeks postoperatively (maximally protective period)
Progress to stage 2 criteria.
1, the strength of the quadriceps muscle is freely controlled and can do straight leg raise with relative ease
2.The knee joint can be fully and passively straightened
3. Passive flexion and extension of the knee joint to 0-90 degrees
4.Good patellofemoral activity
5.Reduced knee swelling
Phase 2 exercise program.
1.Continue the above exercises
2.Add prone knee flexion exercises
3.CAM training
4.Terminal knee extension muscle strength exercises: knee extension strength exercises in the range of knee joint near extension (0~20 degrees), 4 times a day, 1~2 sets, 20 sets each time, 2 minutes rest between sets.
5.Resistance ankle plantar flexion training: against external resistance, toe force downward.
6, knee mobility training: passive knee flexion 0 ~ 90 degrees, active knee flexion 0 ~ 80 degrees
7, foot sliding along the wall training
8.Standing position: straight leg raise training, hook leg training
Stage 3: Controlled walking stage (5~6 weeks after surgery)
Criteria for progression to stage 3.
1.Active knee flexion and extension mobility 0~90 degrees
2. Further reduction of knee swelling
Postoperative week 5 exercise program.
1, patellar luxation
2.Passive knee flexion and extension mobility: 0~105 degrees, active mobility: 0~90 degrees
3, can carry out prone position knee flexion, standing position knee flexion exercise
4. Muscular strength training.
1, straight leg raise: can resist resistance, resistance from 0, 5 pounds (or 250 grams) gradually increased to 5 pounds (2, 5 kg)
2, hip abduction, abduction, back extension resistance training: resistance from 0, 5 pounds (250 grams) gradually increased to 5 pounds (2, 5 kg)
3, micro-squat training (0 ~ 30 degrees), each lasting 30 seconds, 20 repetitions per group, 3 groups per day
5.Biodex training (in the hospital rehabilitation department)
1.Active-assisted knee mobility exercises
2.Quadriceps muscle multi-point isometric strength training
3.Multi-point isometric strength training of N cord muscle
6.Weight-bearing and balance training: training under the guidance of therapists in the rehabilitation department.
1.Partial weight-bearing training for the affected limb in the parallel bar (starting from 25%), weight transfer training from front to back, left to right
2.Walking in the swimming pool for 20 minutes
3.Power bike training for 15 minutes
6 weeks postoperative exercise program.
1.Knee mobility training: passive knee mobility: 0~125 degrees, active mobility: 0~105 degrees
2, N rope muscle resistance training: resistance to flexion of the knee joint
3.Weight-bearing and balance training: partial weight-bearing training of the affected limb in the parallel bar (50%~100%), left-right, front-back transfer training of the center of gravity
4.Backward and forward, lateral stride training
5.Walking training with one crutch
6.Power bicycle training for 15 minutes
Stage 4: 7-12 weeks after surgery (mid-protection stage)
Criteria for progression to stage 4.
1.Active knee flexion and extension mobility 0~125 degrees
2, quadriceps strength loss ≤ 40% (Biodex measurement results)
3, N cord muscle strength loss ≤ 20% (Biodex measurement results)
4.No significant change in KT-1000 measurement
Stage 4 exercise program.
At this stage, the patient can walk completely without crutches
1.Warm-up: power bicycle for 15 minutes
2.Patellar luxation
3, knee flexion and extension mobility: passive knee flexion and extension mobility reached 0~140 degrees, active knee flexion and extension mobility reached 0~120 degrees
4.Strength training.
1, single-leg heel lift training: 20 / group
2, power bike resistance training: 15 minutes
The following exercise methods cannot be applied to all patients. Depending on the condition, the entire rehabilitation program needs to be changed as appropriate. For example, for patients with recurrent shoulder dislocation who have undergone arthroscopic surgery, the above exercises should not be performed on the upper extremity for 4-6 weeks after surgery. Therefore, the specific exercises for each patient should follow the instructions of the treating physician and physical therapist.
When performing postoperative functional exercises, they should be done 5-6 times per day if possible. Each session should last 5-10 minutes. Adequate warming of the shoulder joint on the operated side can be done before the exercise to help improve the mobility of the joint. A cold compress should be applied to the shoulder joint after the exercise to help reduce swelling. Patients are usually discharged from the hospital 3-4 days after the surgery. After discharge, they usually need to return to our hospital 4 times at 3 weeks, 6 weeks, 3 months and 6 months after the surgery. After that, you will have to return to our hospital for 4 times at 3 weeks, 6 weeks, 3 months and 6 months after the surgery, and then once every year after the surgery. The purpose of this review is to allow your doctor to check your shoulder joint rehabilitation and to guide you in the next step of rehabilitation.
Passive joint range of motion exercises (usually performed within the first three months after surgery)
1.Passive forward flexion supination
The patient should lie flat on the bed, straighten the upper arm on the affected side, and hold the elbow of the affected limb with the healthy hand. Without exerting force on the affected limb, the affected limb should be lifted up to the maximum angle by the healthy hand and maintained at that angle for 1 minute.
2.Passive external rotation
The patient lies flat on the bed. The affected elbow is flexed at 90° and placed close to the body side. The hand on the healthy side is held against the palm of the affected hand with a wooden stick. While maintaining the affected elbow joint firmly against the body side, push the affected hand outward as far as possible, and maintain the same for 1 minute when the maximum limit is reached.
Joint pulling exercises (usually performed three months after surgery)
1.Upward pulling exercise
The patient stands facing the wall. The affected limb is elevated and the affected hand is held on the wall. Make the body as close to the wall as possible and try to reach upward with the hand. Maintain for 1 minute while reaching the maximum level.
2.External rotation pulling exercise Find a door frame slightly wider than the width of the patient’s upper body, lift both arms flat, elbow flexion, bilateral forearms on the door frame, make the body lean forward as far as possible, and maintain it for 1 minute when it reaches the maximum degree.